But the re­search—though pub­lished in a re­spected med­i­cal jour­nal—was funded by the U.S. hon­ey in­dus­try. Its au­thors rec­om­mend­ed fur­ther stud­ies to con­firm the re­sults, while not­ing that safe­ty and ef­fi­cacy ques­tions have aris­en around over-the-coun­ter kids’ cough med­i­cines.

“Cough is the rea­son for nearly three per­cent of all out­pa­tient vis­its in the Un­ited States, more than any oth­er symp­tom,” they wrote in the re­port. “It most com­monly oc­curs in con­junc­tion with an up­per res­pi­ra­to­ry tract in­fec­tion,” and of­ten dis­rupts sleep.

The study ap­pears in this mon­th’s is­sue of the Ar­chives of Pe­di­at­rics & Ad­o­les­cent Med­i­cine, pub­lished by the Amer­i­can Med­i­cal As­socia­t­ion. The Na­t­ional Hon­ey Board­—an in­dus­try-funded agen­cy of the U.S. De­part­ment of Agri­cul­ture—paid for the re­search.

The most com­monly used over-the-coun­ter chil­dren’s cough rem­e­dy is dex­tro­meth­or­phan, though it’s un­sup­ported by the Amer­i­can Acad­e­my of Pe­di­at­rics or the Amer­i­can Col­lege of Chest Physi­cians, the stu­dy’s au­thors not­ed. “In many cul­tures, al­ter­na­tive reme­dies such as hon­ey are used,” they added in the re­port.

The re­search­ers, Ian M. Paul and col­leagues at Penn State Col­lege of Med­i­cine, stud­ied 105 chil­dren aged two to 18 with up­per res­pi­ra­to­ry tract in­fec­tions who were sick for a week or less and suf­fered symp­toms at night.

They were ran­domly as­signed to re­ceive an age-appropriate dose of hon­ey, dex­tro­meth­or­phan or no treat­ment for one night with­in half an hour of bed­time. The par­ents were asked to fill out a sur­vey as­sess­ing their child’s cough and sleep the night be­fore and the night af­ter treat­ment.

The sur­vey an­a­lyzed cough fre­quen­cy, cough sev­er­ity and its both­er­some­ness to the child, the child’s sleep and to par­en­ts’ sleep. “Hon­ey was sig­nif­i­cantly su­pe­ri­or to no treat­ment for cough fre­quen­cy and the com­bined score, but dex­tro­meth­or­phan was not bet­ter than no treat­ment for any out­come,” Paul and col­leagues wrote.

“While our find­ings and the ab­sence of con­tem­po­rary stud­ies sup­port­ing the use of dex­tro­meth­or­phan con­tin­ue to ques­tion its ef­fec­tive­ness for the treat­ment of cough as­so­ci­at­ed with up­per res­pi­ra­to­ry tract in­fec­tions, we have now pro­vid­ed ev­i­dence sup­port­ing hon­ey, which is gen­er­ally re­garded as safe for chil­dren old­er than one year, as an al­ter­na­tive,” the au­thors con­clud­ed.

“While ad­di­tion­al stud­ies to con­firm our find­ings should be en­cour­aged, each cli­ni­cian should con­sid­er the find­ings for hon­ey, the ab­sence of such pub­lished find­ings for dex­tro­meth­or­phan and the po­ten­tial for ad­verse ef­fects and cu­mu­la­tive costs as­so­ci­at­ed with the use of dex­tro­meth­or­phan.”

In a 2004 stu­dy, Paul and col­leagues found that nei­ther dex­tromethor­phan nor di­phen­hy­dra­, anoth­er com­mon com­po­nent of cold med­ica­t­ions, per­formed bet­ter than a pla­ce­bo at re­duc­ing night­time cough or im­prov­ing sleep qual­ity.

Some cul­tures have used hon­ey for cen­turies to treat up­per res­pi­ra­tory in­fec­tion symp­toms like cough, and it’s con­sid­ered safe for chil­dren over a year old, the re­search­ers said. Hon­ey soothes on con­tact, they added, and con­tri­butes to wound heal­ing, pos­sibly through its well-es­tab­lished an­ti­mi­cro­bi­al and an­ti­ox­i­dant ef­fects.